Provider Demographics
NPI:1346901360
Name:SURVIVING TO THRIVING LLC
Entity Type:Organization
Organization Name:SURVIVING TO THRIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FULL MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:970-515-3646
Mailing Address - Street 1:3194 FAIRMONT DR UNIT 11B
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80549-1891
Mailing Address - Country:US
Mailing Address - Phone:970-515-3646
Mailing Address - Fax:
Practice Address - Street 1:3194 FAIRMONT DR UNIT 11B
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80549-1891
Practice Address - Country:US
Practice Address - Phone:970-515-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty